Surgical instrument



A. SAPERSTEIN.

SURGICAL INSTRUMENT.

APPLICATION FILED JAN-19, 1921.

7 1,41 6,5 14, Patented May 16,1922.

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IIIIIITIT"I IWITIIHIIIIIIIIIll! l/Vl/E/l/TOR WITNESSES 9 4 S/PEPSTE/N ATTOR/VEYS STATES @FFEQE AARON SAPERSTELN, OF BROOKLYN, NEW YORK.

SURGICAL INSTRUMENT.

emma.

Application filed January 19, 1921.

'York, have invented a new and Improved Surgical-Instrument, of whichthe following is a full, clear, andexact description.

My invention relates to a surgical instrument, and aims to provide adevice of this character which shallpresent certain improvedconstruction over instruments of the class to which it relates, now uponthe market. a

In connection with the removing of tonsils, it is a well appreciatedfact that numerous instruments have been proposed, and

utilized with a view of accomplishing the severance of the tonsils fromthe tissues, with which they are associated.

It is also well known that tonsils vary with respect to ease with whichthey may be removed. Thus it has been found, in some instances, that aphysician will apply the proper instrument to the tonsil and exert acrushing action upon the tonsil holding the same, and that it isnecessary to reapply the instrument to the tonsil, or to substitute aheavier instrument with a view of seven ing the tonsils, by virtue ofthe fact that the same have caused a closer adherence of the tonsil thanhad been anticipated by the physician.

Entirely aside from the foregoing it 1s well understood amongphysicians, that a danger is always present at the time of the removalof the tonsils, in that the severed tonsil is liable to drop into thepassages eX- tending from the mouth to the stomach and lungs. Anaccident of thisnature often results in the death of the patient, and ishence to be guarded against with the greatest of precaution. It is alsowell understood that severance of the tonsils often ..results inhemorrhages, which have sometimes proven fatal, due to theinaccessibility of the tissues severed.

Having the foregoing in mind, I have invented a surgical instrumentwhich. shall primarily be capable of insertion into the mouth of thepatient with a minimum of discomforture, as well as being capable ofhaving its parts dissassembled with a minimum of ease, whereby the samemay be cleansed.

A further object of my invention 1s the Specification of Letters Patent.

Serial No. 438,423.

provision of a device of this character in which 1t will not benecessary for the physi- .cian to resort to a shifting of instruments orof an instrument, upon discovering that the tonsil tends to'adherewith-greater force to the tissues than was primarily anticipated.

A still further object of my invention is the construction of a surgicalinstrument by means of which the tonsil may be removed from the mouthofthe patient without any danger of its becoming lodged in the throat,aslde from the fact that a severance of the vision of a surgicalinstrument which shall effect a severance of the tissues in such amanner that the danger of a hemorrhage re sulting will have been reducedto a minimum.

Further objects of my invention will appear in the annexed specificationand drawings which latter present one practical embodiment of myinvention, and in which;

Figure 1 is a side view ofan instrument embodying my improvedconstruction.

Figure 2 is a plan View thereof and showing the parts prior tothe'initial operation of the same.

Figure 3 is a plan view similar to Figure 2 but showingthe arrangementof the parts while certain of the same have completed the initialmovement.

Figure 1 is a plan view similar to F igures" 2 and 3, but showing theparts in the position which they will assume upon'practically thecompletion of the second operation. a

Figures 5, 6, 7, 8 and 9 illustrate the respective units which, whengrouped together, provide my improved construction, and

Figure 10 is an enlarged sectional view taken-alongthe lines 10-10 inthe direction of the arrows indicated in Figure 1.

Patentedlriay 1+6, 1922.

the body of the travel 19 conveniently provides a flared portion 21adapted to co-operate with the upper edges 22 of the handle 15, whichpresent a dove-tailed openingpreventing any displacement of the traveler19 with respect to the handle 15.

A: crushing blade 23'is secured to the outer end of the traveler 19, andupon a movement of the same it will be seen that the blade 23 will becaused to pass the opening 18, it being noted that the side edges of thetable 17 may conveniently be bent at right angles to the body thereof,to provide guide ele mentsfztin one of which the blade 23 is slidablymounted.

Slidably. interposed between the traveler 19'and traokmember 16 is asnare carrier presenting a body portion 25. This body portion preferablyincludes arscrew threaded stem 26 extending from its rear end, and anysuitable means such studs 27, adjacent its outer end would serve as anattaching'; medium for any. desirable type of snare arranged upon thetrack member 16, the

block 29-of. the same extending into the slot 30 and. being engaged bythe element 31.. Also the snare 28 in its normal position, extendswithinone of'the guide elements 24: presented adjacent the outer end ofthe table portion 17 and beyond the opening 18 thereof.

Further the traveler 19 is slidably arranged upon the body portion 25,the screw threaded stem 26-01 which extends through the opening32'formed in the off set portion 20 ofthe same, and the crushing blade23 attachedto theouter end of the traveler 19 rests in the positionillustrated in Figure 2, i. e. retracted.

Thus it willbe seen that. the outer end of the instrument may beinserted within the patients mouth, and the tonsil caused to lie withinthe opening 18 of the table portion 17. Now upon pressure being exertedupon the offset: portion 20 of the traveler 19, it will be appreciatedthat the crushing blade 23 will be caused to move. slidably within oneof the guiding grooves 24 and exert its proper action upon the tissueattaching the tonsil, resulting in a severance), of the same.

Subsequent to this action a pull upon the elementw3l by means of thefinger of the operator, will cause a retraction of the snare, as hasbeen illustratedv in Figure 1, and it will be obvious that thisretraction will serve to grip the tonsil permitting of its completeremoval, upon the instrument being withdrawn from the mouth of thepatient.

It will be appreciated that at no stage of the operation would it beadvisable to effect a retraction of the plate 23, after it has oncebegun its crushing action. This is to be guarded against, in view of themutilation which would result if the blade were to engage the tissuesrepeatedly at a number of different points, and with this in view, Iconveniently form a seriesof teeth providing a ratchet upon the upperface of the.

traveler 19, a resilient element 34; providing a pawl 35, is alsopositioned upon the upper face of the traveler 19, and serves toretainthe same in proper position with respect'to the track member 16 byvirtue of akey stud which may extend through a slot 37 through the bodyof the traveler, and thence into a key hole slot 38 in the body of theytrack member 16.

From the foregoing it will be appreciated that the parts of myinstrument may however, be retained in assembled relationship by meansof this last element which may be applied by swinging the body 3a of thesame to a position at right angles to the operate as an elementpreventing any aoci dental, retraction on the part of the blade 23,subsequent tO'liS initial pro3ect1on.

Finally to provide suitable means serving to permit manipulation of theblade 23,,

as well as the snare, in the event that the tissues are of greatertoughness than was anticipated, it will be noted that l utilize a handoperated nut 10 of any desirable construction, which is mounted, uponthe screw threaded stem 26, and beyond the off-set finger portion 20.

This element will normally be carried immovable with respect to the stem26, but should the necessity arise, it will be appreciated that arotation of the same will result in a positive projection on the part ofthe blade 23, and a pullbeing exerted upon the snare 28 insuring theready severance of the tonsil.

From the foregoing it will be appreciated that I have constructed asurgical instrument more particularly adapted for use in connection withoperating upon tonsils, but not necessarily limited to this adaptation,and byv means of which a rapid severance of the tonsil may be effected,irrespective of the toughness of the tissues to be crushed.

Also it Will be seen that by means of the pawl and ratchet construction,and particularly the snare that any danger of accidents as pointed outin the preamble of the specification, is reduced to a minimum.

Further, it Will be understood, that the parts may be readilydisassembled for the purpose of sterilization, any suitable means suchas screws 41 afiixed to the outer end of the traveler 19 and the triggerelement 31 serving to permit of the ready detachment of the crushingblade 23 and the trigger for the purpose aforenamed.

Obviously numerous modifications of structure might readily be resortedto with out in the least departing from the spirit of my invention,Which I claim asl. A surgical instrument, including a track member, asnare carrier arranged upon said track member, a traveler positionedupon the body portion of said snare carrier, a table forming the outerend of said track mem-' ber and presenting an opening, a crushing bladeattached to said traveler and adapted to be slidably projected adjacentthe opening of the table, a snare attached to the body portion of saidsnare carrier and adapted to lie adjacent said blade, and normallyencircle the opening of said table, and means for moving said snarecarrier and traveler.

2. A surgical instrument, including atrack member, a snare carrierarranged upon said track member, a traveler positioned upon the bodyportion of said snare carrier, a table forming the outer end of saidtrack member and presenting an opening, a crushing blade attached tosaid traveler and adapted to be slidably projected adjacent the openingof the table, a snare attached to the body portion of said snare carrierand adapted to lie adjacent said blade, and normally encircle theopening of said table, and means for moving said snare carrier andtraveler independently of each other.

3. A surgical instrument, including a track member, a snare carrierarranged upon said track member, a traveler positioned upon the bodyportion of said snare carrier, a table forming the outer end of saidtrack member and presenting an opening, a crushing blade attached tosaid traveler and adapted to be slidably projected adjacent the openingof the table, a snare attached to the body portion of said snare carrierand adapted to lie adjacent said blade, and normally encircle theopening of said table, and means for moving said snare carrier andtraveler, said traveler being formed With a rear end extending at anangle to the body portion thereof and presenting afinger grip.

4r. A surgical instrument, including a track member, a snare carrierarranged upon said track member, a traveler positioned upon the bodyportion of said snare carrier, a table forming the outer end of saidtrack member and presenting an opening, a crushing blade attached tosaid traveler and adapted to be slidably projected adjacent the openingor the table, a snare attached to the body portion of said snare carrierand adapted to lie adjacent said blade, and normally encircle theopening of said table, and means for moving said snare carrier andtraveler, and a finger engageable element secured to said snare carrierfor moving the same.

5. A surgical instrument, including a track member, a snare carrierarranged upon said track member, a traveler positioned upon the bodyportion of said snare carrier, a table forming the outer end of saidtrack member and presenting an opening, a crushing blade attached tosaid traveler and adapted to be slidably projected adjacent the openingof the table, a snare attached to the body portion of said snare carrierand adapted to lie adjacent said blade and normally encircle the openingof said table, and means for moving said snare carrier and travelerindependently of each other, a screw threaded stem secured to the bodyportion of said snare carrier and extending through an opening in thefinger portion of said traveler, and a nut engaging said screw threadedstem.

AARON SAPERSTEIN.

